Screening for prostate cancer

Checking for prostate cancer when you have no symptoms is called prostate screening.

Ireland and other European countries do not offer a routine national prostate screening programme. It is not known for sure if routine prostate screening can reduce the number of deaths from prostate cancer.

A national screening program could increase the numbers of men having unnecessary treatment for very slow growing prostate cancer, which could lead to many men experiencing worse side-effects as a result of treatment than they would from the cancer.

Deciding to have prostate cancer screening done is a personal decision and should be based upon having a full discussion with your doctor beforehand in order to weigh up the pros and cons.This way you will have a greater understanding of what the test involves, and an understanding that it could lead you to having to make further important decisions which might affect your life now, and perhaps in the future.

If you choose to go for prostate screening your doctor will carry out a physical examination and will also take a blood test from you. The blood test measures Prostate Specific Antigen (PSA).

PSA is made by normal prostate cells as well as by prostate cancer cells. If your PSA level is higher than normal, it can sometimes be a sign of prostate cancer. But often it can be a sign of a less serious condition like an enlarged or inflamed prostate.

Who should consider having a PSA test?

Discuss how you feel about having a PSA test with your GP. Men over 50 should be aware of the risk factors for prostate cancer and consider the following questions:

Am I at risk of prostate cancer?

Do I have any urinary or prostate problems?

What would I choose to do if my PSA is raised?

What would I do if I were diagnosed with early prostate cancer?

If you have a family history of prostate cancer or are in another high-risk group you could discuss with your GP the option of having a PSA test from the age of 40. If you have no family history and are not in a high-risk group, many doctors feel it is best to discuss the possibility of a PSA test from the age of 50.

After having the first test done some men, in particular those men who are in a high-risk group, may decide to have this test repeated regularly.

How often this test needs to be repeated can be discussed with your doctor, as the frequency may be influenced by the PSA level, your age and the degree of risk.

Routine PSA testing in men over 70-75 is not advised due to the slow-growing nature of prostate cancer. However, it may be necessary if the prostate gland is felt abnormal on examination by the GP or if you are having prostate urinary problems.

Where do I have a PSA blood test?

If you are considering having a PSA test it should be done with your GP after full discussion with you about the pros and cons of the PSA test. Your GP will send the blood sample to a hospital for measurement. It may take a week or two before your GP gets the result.

Home PSA test kits are available, but prostate problems are best diagnosed by your GP, who can take your medical history and carry out a physical examination, as well as doing the PSA test. By attending your GP you can also discuss prostate cancer risk factors and talk about any concerns you may have about the test and its results when they are available.

How reliable is the PSA test?

The PSA blood test is not reliable to diagnose prostate cancer. The PSA can be raised for other non-cancerous reasons like recent urinary tract infection, prostatitis (infection in the prostate) or an enlarged prostate as a result of ageing.

The higher the PSA level, the more likely you are to have prostate cancer, but in early prostate cancer the PSA level may be only slightly raised.

It is also important to know that a small number of men could have prostate cancer and have a normal PSA level.

Questions about prostate cancer?

If you are concerned about prostate cancer, contact our Cancer Nurseline on Freefone 1800 200 700 for confidential advice, support and information. You can also send us your questions online at www.cancer.ie/nurseline or email your query.